Simultaneous, Bilateral Pathological Displaced Intracapsular Hip Fractures Occurring Spontaneously Secondary to Osteomalacia of Hypomagnesemic Origin: A Case Report and Review of the Literature

Abstract

Spontaneous fractures involving both of the femoral necks simultaneously are exceedingly rare events. We report a case of an elderly female who presented after breaking both femoral necks following a trivial fall, initially diagnosed as age-related osteoporosis. Both the hips were treated by hemiarthroplasty. The diagnosis was revised to vitamin D-resistant osteomalacia secondary to hypomagnesemia after histopathological confirmation and further investigations. We examine the different etiological factors and mechanisms operating in the causation of this rare injury and explore the possible role of magnesium in the pathogenesis of osteomalacia. Fractures may remain occult until late, leading to increased morbidity and mortality. The value of an early MRI is recapitulated, with emphasis placed on prevention and early fixation.

Keywords: Bilateral; Femoral neck; Fractures; Hypomagnesemia; Osteomalacia; Simultaneous; Spontaneous.